Provider Demographics
NPI:1316922297
Name:JOCSON, MICHAEL ERNEST (PT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ERNEST
Last Name:JOCSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:4005 BEACON RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5343
Mailing Address - Country:US
Mailing Address - Phone:718-219-5560
Mailing Address - Fax:718-260-6124
Practice Address - Street 1:1119 4TH ST
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3001
Practice Address - Country:US
Practice Address - Phone:718-219-5560
Practice Address - Fax:718-260-6124
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16367225100000X, 2251G0304X, 2251S0007X, 2251X0800X
FLPT363002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP36828Medicare UPIN
NY04698Medicare PIN